Drugs that act directly on the renin-angiotensin system
can cause injury and death to the developing fetus.

DRUG DESCRIPTION

ATACAND (candesartan cilexetil), a prodrug, is hydrolyzed
to candesartan during absorption from the gastrointestinal tract. Candesartan
is a selective AT1 subtype angiotensin II receptor antagonist.

Candesartan cilexetil, a nonpeptide, is chemically
described as (±)-1-Hydroxyethyl 2-ethoxy-1-[p-(o-1H-tetrazol-5ylphenyl)benzyl]-7-benzimidazolecarboxylate,
cyclohexyl carbonate (ester).

Its empirical formula is C33H34N6O6,
and its structural formula is:

Candesartan cilexetil is a
white to off-white powder with a molecular weight of 610.67. It is practically
insoluble in water and sparingly soluble in methanol. Candesartan cilexetil is a
racemic mixture containing one chiral center at the cyclohexyloxycarbonyloxy
ethyl ester group. Following oral administration, candesartan cilexetil
undergoes hydrolysis at the ester link to form the active drug, candesartan,
which is achiral.

ATACAND is available for oral
use as tablets containing either 4 mg, 8 mg, 16 mg, or 32 mg of candesartan
cilexetil and the following inactive ingredients: hydroxypropyl cellulose,
polyethylene glycol, lactose, corn starch, carboxymethylcellulose calcium, and
magnesium stearate. Ferric oxide (reddish brown) is added to the 8-mg, 16-mg,
and 32-mg tablets as a colorant.

What are the possible side effects of candesartan (Atacand)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, candesartan can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.

What are the precautions when taking candesartan cilexetil (Atacand)?

Before taking candesartan, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, high blood levels of potassium in the blood (hyperkalemia), loss of too much body water and/or minerals (volume depletion, dehydration).

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.